Scabies bites facts

 Scabies is an itchy, highly contagious skin disease caused by an infestation by the itch mite

Sarcoptes scabiei.

 Direct skin-to-skin contact is the mode of transmission.

 A severe and relentless itch is the predominant symptom of scabies.

 Sexual contact is the most common form of transmission among sexually active young people,

and scabies has been considered by many to be a sexually transmitted disease (STD), although

not all cases are transmitted sexually.

 Signs and symptoms of scabies include a skin rash composed of small red bumps and blisters

that affects specific areas of the body. Other symptoms can include tiny red burrows on the skin

and relentless itching. The itchy skin leads to frequent scratching, which may predispose the skin

to secondary infections.

 Treatment includes oral or topical scabicidal drugs.

 Over-the-counter remedies or home remedies are not effective in eliminating scabies.

hat is scabies? What causes a scabies infestation?

Scabies is an itchy, highly contagious skin disease caused by an infestation by the itch mite Sarcoptes

scabiei. Mites are small eight-legged parasites (in contrast to insects, which have six legs). They are tiny,

just 1/3 millimeter long, and burrow into the skin to produce intense itching, which tends to be worse at

night. The mites that infest humans are female and are 0.3 mm-0.4 mm long; the males are about half this

size. Scabies mites can be seen with a magnifying glass or microscope. The scabies mites crawl but are

unable to fly or jump. They are immobile at temperatures below 20 C, although they may survive for

prolonged periods at these temperatures.

Scabies infestation occurs worldwide and is very common. Scabies can affect anyone of any age

(including a baby or child) or race. It has been estimated that about 300 million cases occur each year

throughout the world. Human scabies has been reported for over 2,500 years. Scabies has been reported

to occur in epidemics in nursing homes, hospitals, long-term care facilities, and other institutions. In the
 U.S., scabies frequently affects the homeless population. It also occurs episodically in other populations

of all socioeconomic groups, as well.

Is scabies contagious? How do you get scabies?

Scabies is very contagious, and direct skin-to-skin contact is the mode of transmission. Scabies mites are

very sensitive to their environment. They can only live off of a host body for 24-36 hours under most

conditions. Transmission of the mites involves close person-to-person contact of the skin-to-skin variety,

so risk factors include close contact with an infested person. It is hard, if not impossible, to catch scabies

by shaking hands, hanging your coat next to someone who has it, or even sharing bedclothes that had

mites in them the night before. Sexual physical contact, however, can transmit the disease. In fact, sexual

contact is the most common form of transmission among sexually active young people, and scabies has

been considered by many to be a sexually transmitted disease (STD). However, other forms of physical

contact, such as a mother hugging a baby, are sufficient to spread the mites. Over time, close friends and

relatives can contract it this way, too. School settings typically do not provide the level of prolonged pand

signs? What does scabies rash look like?

 Scabies produces a skin rash composed of small red bumps and blisters and affects specific

areas of the body.

 Scabies may involve the webs between the fingers, the wrists and the backs of the elbows, the

knees, around the waist and umbilicus, the axillary folds, the areas around the nipples, the sides

and backs of the feet, the genital area, and the buttocks.

 The bumps (medically termed papules) may contain blood crusts. It is helpful to know that not

every bump is a bug.

 In most cases of scabies affecting otherwise healthy adults, there are no more than 10-15 live

mites even if there are hundreds of bumps and pimples on the skin.

The scabies rash is often apparent on the head, face, neck, palms, and soles of the feet in infants and

very young children but usually not in adults and older children.
Textbook descriptions of scabies always mention "burrows" or "tunnels." These are tiny threadlike

projections, ranging from 2 mm-15 mm long, which appear as thin gray, brown, or red lines in affected

areas. The burrows can be very difficult to see. Often mistaken for burrows are linear scratch marks or

welts that are large and dramatic and appear in people with any itchy skin condition. Scratching actually

destroys burrows. Scratching may open the skin and lead to scab formation.

ersonal contact necessary for transmission of the mites.

What does scabies feel like?

It is important to note that symptoms may not appear for up to two months after being infested with the

scabies mite. Even though symptoms do not occur, the infested person is still able to spread scabies

during this time. When symptoms develop, itching is the most common symptom of scabies. Scabies

does not cause pain. The itch of scabies is insidious and relentless and often worsens over a period of

weeks. The itch is typically worse at night. For the first weeks, the itch is subtle. It then gradually becomes

more intense until, after a month or two, sleep becomes almost impossible due to the intensely itchy skin.

What makes the itch of scabies distinctive is its relentless quality, at least after several weeks. Other itchy

skin conditions -- eczema, hives, and so forth -- tend to produce symptoms that wax and wane. These

types of itch may keep people from falling asleep at night for a little while, but they rarely prevent sleep or

awaken the sufferer in the middle of the night.

How do health care professionals diagnose a scabies infestation?

Scabies is suggested by the presence of the typical rash and symptoms of unrelenting and worsening

itch, particularly at night. Ultimately, the definitive medical diagnosis is made when evidence of mites is

found from a skin scraping test. By scraping the skin (covered with a drop of mineral oil) sideways with a

scalpel blade over an area of a burrow and examining the scrapings microscopically, it is possible to

identify mites, eggs, or pellets. This process can be difficult, however, since burrows can be hard to

identify. Sometimes scratch marks are mistaken for burrows, and even the examination of scrapings from

15 or more burrows may only reveal one or two mites or eggs. If the characteristic physical findings are

present, scabies can often be treated without performing the skin scrapings necessary to identify the

mites. Polymerase chain reaction (PCR) testing is available to identify the genetic material of the scabies
 mites when the diagnosis is difficult, though this is not generally used. The mites can also be identified in

skin biopsies that are performed when other causes of skin disease are suspected.

What types of health care professionals treat scabies?

Scabies is treated by a number of different health-care professionals. The medical condition is commonly

treated by primary-care doctors, including pediatricians, internal-medicine specialists, and family medicine

doctors. Many patients with skin symptoms seek treatment from a dermatologist or pediatric

dermatologist. Sometimes, the condition may be first treated by an emergency-medicine doctor if the

patient seeks care in an emergency department.

What are treatment options and home remedies for a scabies infestation? What are scabies treatments
for pregnant women?

 Readers Comments 90

 Share Your Story

Curing scabies is rather easy with the administration of prescription scabicide drugs. There are no

approved over-the-counter preparations that have been proved to be effective in eliminating scabies, and

home remedies are not effective. Since scabies is a parasitic infestation, antibiotics used to treat bacterial

infections are not effective. The following steps should be included in the medical treatment of scabies:

1. Apply a mite-killer like permethrin (Elimite). These creams are applied from the neck down, left on

overnight, then washed off. This application is usually repeated in seven days. Permethrin is

approved for use in people 2 months of age and older and is considered to be the safest and most

effective treatment for scabies.

An alternative treatment is 1 ounce of a 1% lotion or 30 grams of cream of lindane, applied from

the neck down and washed off after approximately eight hours. Since lindane can cause seizures
when it is absorbed through the skin, it should not be used if skin is significantly irritated or wet,
such as with extensive skin disease, rash, or after a bath. As an additional precaution, lindane
should not be used during pregnancy or in nursing women, the elderly, people with skin sores at
the site of the application, children younger than 2 years of age, or people who weigh less than
110 pounds. Lindane is not a first-line treatment and is only recommended if patients cannot
tolerate other therapies or if other therapies have not been effective. Resistance to this medication
has also been What are treatment options and home remedies for a scabies infestation? (Part 2)
 3. Ivermectin (Stromectol), an oral medication, is an antiparasitic medication that has also been

shown to be an effective scabicide, although it is not FDA-approved for this use. The CDC

recommends taking this drug at a dosage of 200 micrograms per kilogram body weight as a

single dose, followed by a repeat dose two weeks later. Although taking a drug by mouth is more

convenient than application of the cream, oral ivermectin has a greater risk of toxic side effects

than permethrin and has not been shown to be superior to permethrin in eradicating scabies. It is

typically used only when topical medications have failed or when the patient cannot tolerate them.

4. Crotamiton lotion 10% and cream 10% (Eurax, Crotan) is another drug that has been approved

for the treatment of scabies in adults, but it is not approved for use in children. However,

treatment failures have been documented with the use of crotamiton.

5. Sulfur in petrolatum (Sulfo-Lac, Sulfo-Lo) applied as a cream or ointment is one of the earliest

known treatments for scabies. It has not been approved by the FDA for this use, and sulfur

should only be used when permethrin, lindane, or ivermectin cannot be tolerated. However, sulfur

is safe for use during pregnancy and in infants.

What are treatment options and home remedies for a scabies infestation? (Part 3)

6. Antihistamines, such as diphenhydramine (Benadryl), can be useful in helping provide relief from

itching. Sometimes, a short course of topical or oral steroids is prescribed to help control the

itching.

7. Wash linens and bedclothes in hot water. Because mites don't live long away from the body, it is

not necessary to dry-clean the whole wardrobe, spray furniture and rugs, and so forth.

8. Treat sexual contacts or relevant family members (who either have either symptoms or have the

kind of relationship that makes transmission likely).

Just as the itch of scabies takes a while to reach a crescendo, it takes a few days to subside after

treatment. After a week or two, relief is dramatic. If that doesn't happen, the diagnosis of scabies must be

questioned.